Addicts turn to heroin, other drugs to replace OxyContin

Local needle exchange program sees large spike

Pinewood Centre

OSHAWA -- An Oshawa resident who has gone through treatment at the Pinewood Centre recently discussed her battles with addiction and what it took for her to get clean. July 5, 2013.

John Howard Society

Ryan Pfeiffer / Metroland

OSHAWA -- Beth Whalen is the co-ordinator of harm reduction services at the John Howard Society of Durham. She has seen a large increase in the use of the needle exchange program in the past year. July 31, 2013.

John Howard Society

Ryan Pfeiffer / Metroland

OSHAWA -- Beth Whalen is the co-ordinator of harm reduction services at the John Howard Society of Durham. She has seen a large increase in the use of the needle exchange program in the past year. July 31, 2013.

John Howard Society

Ryan Pfeiffer / Metroland

OSHAWA -- Beth Whalen is the co-ordinator of harm reduction services at the John Howard Society of Durham. She has seen a large increase in the use of the needle exchange program in the past year. July 31, 2013.

Pinewood Centre

Ryan Pfeiffer / Metroland

OSHAWA -- An Oshawa resident who has gone through treatment at the Pinewood Centre recently discussed her battles with addiction and what it took for her to get clean. July 5, 2013.

DURHAM -- She lost her job, her kids and almost her life in a destructive spiral that started three and a half years ago when she first tried shooting OxyContin.

Now, Mary -- not her real name -- is on the path to recovery with support from Durham’s Pinewood Centre and her loved ones.

“Even when everything is at its worst and you’re scraping that bottom of the barrel, you just have to find that faith that you can do this ... if you put that effort in, you can get better,” she said. “But it’s never going to be easy, it’s going to be work.”

After alcohol, opiates are the most common addiction treated at the Pinewood Centre. Officials from Pinewood and the John Howard Society report changes last year to the availability of OxyContin, a brand name for oxycodone, has had a major impact on Durham opiate drug users, plunging some into crisis.

In March 2012, the Province de-listed oxycodone products from the Ontario Drug Benefit Program after the number of prescriptions for oxycodone rose by 900 per cent between 1991 and 2009 and Ontario logged the highest rates of opioid use in the country. At the same time, Purdue Pharma, the manufacturer of OxyContin, changed the drug’s formula and reintroduced it as OxyNeo, a more tamper-resistant version of the drug which turns into a gel when crushed and added to water, making injecting it intravenously more difficult.

“The criteria became much stricter on who would qualify for OxyNeo,” explained Stacey Simon, senior opiate case manager at Pinewood Centre.

Beth Whalen, the co-ordinator of harm reduction services for the John Howard Society, including the Project X-Change needle exchange program, said opioid users have found ways to break the tamper-resistance on OxyNeo, but it takes time and it’s still not the same as OxyContin, so they’re switching to other prescription drugs such as Dilaudid, a hydromorphone, and fentanyl.

“Or heroin, which we never saw here before and now there’s an abundance of it,” she said. “It wasn’t here until OxyContin was taken off the drug benefit plan.”

A change is clear in the sharp increase in the number of needles distributed across Durham.

In 2012, the John Howard Society distributed 298,523 needles, down slightly from 2011. But this year, Ms. Whalen said Project X-Change had already distributed more than 200,000 needles by the end of June and she expected the number to hit more than 400,000 by the end of the year.

“When OxyContin was taken off the shelf, most people in harm reduction predicted most people wouldn’t be running for treatment or methadone programs and sadly we were right,” said Ms. Whalen. “Ninety per cent of our clients are addicted to some form of an opiate.”

As people try new drugs, the risk of overdose increases.

“There’s definitely an increased risk of overdose and you’re seeing more cases of people accidentally overdosing on drugs they weren’t using before,” said Ms. Simon, who said she believes the changes have likely led to more hospital visits.

For example, drug users will break down fentanyl time-release patches, but when they do so they can never be certain about the exact amount of drugs they’re shooting or ingesting. The strength of illegal drugs like heroin varies by the batch.

Cindy Kwok, co-ordinator for opiate case management services at Pinewood, explained that drug addiction brings numerous issues for people including financial, family and employment problems as well as deteriorating health.

Those were all issues for Mary, an Oshawa resident, who said that before she came into the world of drugs and addiction, she used to turn her nose up at addicts. But after leaving a bad marriage, she got involved with a partner who was supposedly a recovering addict. Once the couple began living together, it was clear Mary’s partner was still using.

“I couldn’t get them to stop ... so I said listen if you’re doing this I want to know what it’s about, why you can’t stop,” explained Mary.

Then she made what she calls the biggest mistake of her life and allowed her partner to shoot her up with OxyContin.

“I never dreamed that trying it once would cause the destruction that it did,” she said. “All of those stresses I was going through, with my divorce, my custody battle, didn’t matter.”

She quickly spent tens of thousands of dollars on narcotics to support both their habits including maxing out credit cards, selling family heirlooms at pawn shops and lying to friends and family to get money.

“There came a point where I couldn’t even cover the rent and I didn’t care.”

Although she never stole from her employer, her addiction caused her work performance to suffer and she was fired.

After five months of using OxyContin and trying to quit on her own with no success, a friend took her to the local hospital and she went to Pinewood for detox.

Mary understands well why it’s so hard for opiate addicts to quit. She describes withdrawal symptoms like a terrible flu including throwing up and sweating and being unable to control her kicking.

“You get so sick you’ll do anything to get another pill to stop the sickness.”

She also lost custody of her children.

It wasn’t a straight road to recovery for her after detox; she battled alcohol and went through relapses. When OxyContin was no longer available, she turned to drugs like Dilaudid. But Mary said she’s now been clean for nine months and feels like she’s turned a corner.

Part of her treatment included using Subuxone which, like methadone, is an opiate substitute.

Ms. Kwok explains that both methadone and Subuxone prevent the symptoms of withdrawal, but it doesn’t give people the euphoric feeling that using drugs does.

Some clients will taper off opiate substitutes, like Mary did, while others will continue to use it for a longer period, allowing them to resume their regular lives.

“The main thing is looking at quality of life,” said Ms. Kwok.

“There’s lots of people on methadone and Subuxone, it could be your grocery clerk or your bank teller or your next door neighbour,” said Ms. Simon.

Ms. Whalen believes the key to helping people is making addiction services more readily available, easing the transition from detox to in-patient treatment, for which many still must sit on a waiting list. To help more people, Pinewood has recently increased the number of opiate case managers to work closely with clients to deal with issues like housing, finances and mental health.

But everyone agrees that individual users must be ready for help and ready for change. And even then it’s no easy road. Nine months clean, Mary has gotten her job back and now shares 50-50 custody of her children with her ex-husband.

“It’s amazing how these drugs take a hold of you and they just don’t let go, it’s been really difficult,” she said. “My purpose is my children, my spouse, my job and my family. I have to keep that in sight. I’ve lost relationships I’ll never recover, but it’s important to remember this kind of addiction needs consistent support.

“There’s really no boundary for this kind of addiction ... it could happen to anybody. Pre-addiction, I never realized that, I never believed it could happen to someone like me.”

Reporter Reka Szekely covers the City of Oshawa for Metroland Media Group’s Durham Region Division. Reka's social media column appears every other week. Contact her on Facebook, Twitter (@rszekely)